Abstract

Liver transplantation is currently the most effective method for treating end-stage liver disease. However, recipients still need long-term immunosuppressive drug treatment to control allogeneic immune rejection, which may cause various complications and affect the long-term survival of the recipient. Many liver transplant researchers constantly pursue the induction of immune tolerance in liver transplant recipients, immunosuppression withdrawal, and the maintenance of good and stable graft function. Although allogeneic liver transplantation is more tolerated than transplantation of other solid organs, and it shows a certain incidence of spontaneous tolerance, there is still great risk for general recipients. With the gradual progress in our understanding of immune regulatory mechanisms, a variety of immune regulatory cells have been discovered, and good results have been obtained in rodent and non-human primate transplant models. As immune cell therapies can induce long-term stable tolerance, they provide a good prospect for the induction of tolerance in clinical liver transplantation. At present, many transplant centers have carried out tolerance-inducing clinical trials in liver transplant recipients, and some have achieved gratifying results. This article will review the current status of liver transplant tolerance and the research progress of different cellular immunotherapies to induce this tolerance, which can provide more support for future clinical applications.

Highlights

  • Liver transplantation has been a preferred option for patients with end-stage liver disease

  • There is no clear clinical effect, the purity and stability of cell-induced therapy and its safety for longterm recipients should still be explored for a long time, as many issues need to be observed

  • With the development of multi-center clinical trials, we are optimistic about the good prospects for liver transplant tolerance

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Summary

INTRODUCTION

Liver transplantation has been a preferred option for patients with end-stage liver disease. Since Dr Starzl performed the first human liver transplantation in 1963, the short-term survival rate of liver transplant recipients has improved significantly, which can be attributed to advances in surgical techniques and immunosuppression (IS) agents [1]. Owing to the long-term use of IS agents, complications concerning the cardiovascular and cerebrovascular systems, diabetes, chronic renal insufficiency, infection, or tumors seriously affect the long-term survival of liver transplant recipients [2, 3]

Liver Transplant Tolerance
CURRENT STATE IN SPONTANEOUS TOLERANCE
Single CNI
Allogeneic HSCT Inducing Chimerism
Autologous HSCT Inducing Chimerism
REGULATORY DENDRITIC CELLS IN LIVER TRANSPLANT TOLERANCE
SUMMARY AND FUTURE DEVELOPMENT
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